TBI S-O-S! Restoring a Sense-Of-Self after Brain Injury and Concussion

Communication Issues

Communication issues after TBI can be a problem. There’s the trouble you may have expressing yourself, the trouble you may have understanding others, the trouble finding words, or just communicating in general. Communication is a two-way street, and I’ve found that in my own case, that street can sometimes be “under construction” with plenty of potholes and speed bumps and detours. The trick, in my experience, is to not give up, keep asking for clarification, and not quit until that road is traveled to everyone’s satisfaction — especially mine.

Having problems reading others’ emotions and not responding appropriately to another person’s feelings or to the social situation.

Misunderstanding jokes or sarcasm.

These problems can be caused by aphasia, having trouble understanding and producing spoken and/or written language, or problems with attention and distraction. They can be directly caused by problems with specific speech/language “wiring”, or they can be related to distractability or short-term working memory issues. In my case, my pitiful short-term/working memory is a big culprit — I tend to forget what people said just a minute ago, so that can make it hard to communicate. Also, when I am tired, it makes everything harder, so if I’m involved in a long conversation about something important, I can run out of steam and have a harder and harder time as the conversation progresses.

Here are some links to help you better understand communication issues after TBI:

Communication Issues after Brain Injury can include:

4. Trouble being understood – No matter how hard you try, others can’t quite seem to “get” what you’re saying. This happens to me all the time, and it appears to have its roots in a number of sources:

I have trouble organizing my thoughts.

I get distracted by unrelated details or things that are happening around me and I tend to forget what point I was trying to make.

I have trouble figuring out what information is most important to communicate to others. It all seems important to me, but not all of it is.

I am nervous about communicating with others, because I have a crappy track record of it.

I get distracted while talking to the other person, so I don’t pick up all the clues they are sending about whether or not they understand me.

I have spent an awful lot of time NOT communicating with others, so I’m more out of practice than many.

Other people don’t always pay attention to what I’m saying. They get lost in their own thoughts and interpretations and they “project” onto me their own biases and opinions, which skew what I’m actually trying to say.

Other people don’t always take me that seriously, because I don’t parade around with a lot of gravitas that tells the world “I’m really important and you need to listen to me.” So, they seem to interpret this as insignificance on my part.

I get tired, and when that happens, everything goes haywire.

What to do about trouble being understood?

Take some time to organize your thoughts before you start talking. If you can do this (and sometimes you can’t, because things are happening “on the fly”), take some time to figure out the exact point you want to make — and then stick to that.

Keep it short and sweet. We can often say more than enough in a sentence or two, rather than the paragraphs our minds come up with. Getting nervous can make you say the same thing in ten different ways, and people can stop listening to you after the thrid or fourth version. Less is often more, in communication.

Keep trying and don’t give up, until you are sure that the other person fully understands what you’re saying. You don’t want to overwhelm the other person, but you do want to be sure that they understand you. Just keep at it, and ask them to summarize what they think you just said. If they’ve got it wrong — and it’s possible they have — keep reiterating your point until you are confident that they understand.

Try to communicate in a number of different ways. Use illustrations or stories — just don’t get too far afield, you don’t want to lose them by wandering. Use analogies, if you can think of them, and use different words to “flesh out” your point.

Pay close attention to what they other person is saying and/or doing in response to your words. If they are fidgeting and obviously nervous, there’s a good chance they are not getting everything you’re saying, because they are experiencing a stress response that’s limiting their cognitive range. If they are stressed or nervous or anxious, try to mirror their body language — that can make people feel more comfortable with you. I’ve done that for years, and while it feels bogus and contrived, it actually seems to work. People like to be mirrored, so try moving your body in the same ways that they do — if they have their arms crossed, cross yours. If they are running their hands through their hair, do that too. If they are rubbing their chin, try that. See how that works.

Likewise, pay attention to how you’re feeling — if you’re stressed, your own cognitive range is going to be narrowed, and it’s going to make everything harder. Do some slow breathing and consciously relax. Think about something nice and relaxing, and “let go” of the tension. It’s going to be okay. You can do this. Even if you’re struggling, remember — other people struggle all the time, and they still manage to make it through the day. Plus, this is a good learning experience for you. You can take another look at what happened later, when you have some perspective, and figure out what worked and what didn’t.

Don’t assume that others don’t understand you. Sometimes they actually do, you are just not realizing it, because you’re not getting the clues. Be gentle with yourself and don’t assume the worst. This just makes things harder.

Feeling like you can’t communicate can be stressful, even terrifying. People are social creatures, and even if you’re not very social, yourself, the rest of the world is, so unless you’re independently wealthy with servants to do the job for you, you’re going to have to talk to someone, at some point on down the line. Especially if you’re dealing with public agencies, doctors, lawyers, healthcare providers, teachers… anyone who is in a profession to assist or interact with you. Being able to communicate your ideas and thoughts and needs and requirements is an important skill, so most of all, don’t give up — just keep trying until you are sure you’ve been understood.

5. Trouble understanding

[ coming soon… ]

6. Trouble finding words

[ coming soon… ]

7. Trouble communicating in general

[ coming soon… ]

Advertisements

Share this:

Like this:

13 thoughts on “Communication Issues”

For myself, I find the written word to be the preferred route. Unfortunately, bosses don’t really understand. I am thankful that I have language skills. Composing thoughts is pretty good, but when put in a situation where more attention is required, and people are seemingly upset with my rate of processing widgets, and asking for me to do more processing of widgets, and do all of the other stuff associated with working, it can get a bit overwhelming.

Not ME – I popped out of the WOMB talking a blue-streak ::grin:: – but I find writing captures details more precisely — and leaves a few bread crumbs for me to follow after some time in the witches house. The verbal/auditory ones tend to get gobbled up by critters before I need them.

I had to rush to read – but I don’t think I saw another problem most common in the autistic spectrum community, but I KNOW the TBI crowd experiences too – auditory discrimination deficits.

For many who struggle in this domain, every conversation that isn’t strictly one-on-one – in private – is similar to the experience of someone with a so-called neurotypical-brain trying to pick up a hottie in a crowded disco.

It doesn’t matter how much you are attempting to show him or her you are oh-so-interested and hanging on to every word, you simply can’t make out what s/he is saying above the din. You can HEAR, you just can’t follow because you miss words whenever anything else gets louder (or you get brain fatigue).

So we “punt,” nodding and grinning in response to what we THINK is being said. Sometimes we get away with it – but sometimes we respond totally inappropriately, misreading the visual cues or tonal inflections, and sometimes we seem to be agreeing to something we never even heard.

In the workplace, that can make you look like you’re not “a team player” – or worse, like the village idiot. The fix? 1-2-3-4 simple:

1. STOP THEM – hold up one finger to get them to pause
2. MOVE THEM – then use that finger in “follow me” gesture to move them a bit out of the noise.
3. EXPLAIN (briefly) and AFFIRM (lean in and lower your voice, as if this is just between you two) – “Sorry, I have a slight hearing problem when there is more than one conversation in the room – auditory discrimination – and I want to make sure I don’t miss what you’re saying to me. I’m sure it’s important.
4. GET THEM BACK ON TRACK – Back up, raise your voice to a normal volume and say, “Now, what were you saying again?”

TRUST ME – they don’t want to hear about auditory discrimination (unless they do – then you get to be seen as informed rather than clueless). Some people will actually take over the “move you to a quieter place” responsibility BEFORE attempting to talk with you — but if they don’t, you only have to do numbers 1 and 2 and they will remember and pick right up where they left off.

You know, it’s funny — apparently when I was a kid, I was really outgoing and talked a blue streak, even before I could form proper words. Then I got hurt, and life became… well, life… and it sorta kinda got the better of me for, oh, about 35 years. I faintly remember, as a kid, having lots and lots of really involved conversations with people. And sometimes I still do. Only now, I’ve got the auditory business to deal with.

But like you said, there are ways around that.

Just yesterday, in fact, I did something similar to what you described. I went out to lunch with my team, and they sat us down at a table in the middle of a very busy, very loud restaurant. Well, sh*t. They always put us there, when we go there — lots of people talking loud, the televisions all on and blaring, music in the background, and the hustle and bustle of the kitchen right in front of me (I probably should have sat with my back to the action, but there was actually action all around).

The hostess came by and took our drink orders, and I could barely hear her. In fairness, she could barely hear us, either, but it didn’t seem to ruin her day, like it does for me sometimes. I had a couple of questions about the soup of the day, location of restrooms, etc., so rather than battling the crowds, I waited until she was done talking to everyone and then got up and went over and asked her, standing so that I could actually hear what she was saying. I had a bunch of questions, and I got them all answered, and frankly she seemed glad to be talking directly to someone who was clearly making an attempt to understand her. No mention had to be made of auditory discrimination. *Nobody* could friggin’ hear much at all in that place. The main difference with me was that I allowed for it and worked around it. And that was good.

The rest of the meal kind of sucked, because things are tense at work between some folks on the team, and because the uber-uber boss was there, I had to feign interest in what they were saying. Tiresome – and difficult when there is so much going on around me.

End of the day… exhausted. Went to bed early.

But my interaction in the restaurant was very productive and pleasant, too. Both the hostess and I actually had a conversation we could understand. Nice.

You bring up a number of issues you seem to be all too aware of the need to manage – as well as how exhausting it is to have to struggle to cope in stressful situations (psychologically) in addition to neurologically.

GOOD FOR YOU for putting yourself to bed early – and good job working on that self-acceptance/entitlement to get your needs met thing. So difficult for ALL of us.

Nice, too, when everyone else is equally disadvantaged (noisy etc.) – we don’t feel so much like zebras among horses.

But ‘sup with the bosses to put everyone in that environment as a “team building” deal? Mayhaps they really don’t WANT much discussion?

Why yes they do, so that is fine. I think, on second thought, it’s not only cluelessness that drives things – it’s also a kind of testing/proving — to see how well you can function under out-and-about kinds of circumstances. That, and the uber-uber boss thrives on chaos — and is also a bit tipsy half the time. I’m outa there, soon, so I can afford to be entertained by the whole scene.

Years ago, I briefly worked in a firm (which shall remain nameless) where I reported directly to 2 top Execs. I was told by one on my FIRST day that the other –
#1 got NO originals (loses them)
#2-drank lunch, so coordinate only in AM with that person

Having all of this written down for me to refer to is great. My TBI accident anniversary was a couple of months ago, it has been 28 years. My TBI has recently (2 years) started giving me extreme issues with Cognition. It’s like I’m starting all over again after my car accident. I have PTSD so bad I don’t sleep well, nor do I enjoy life.

Reading this information is great, but how do you remember it? I’m in the beginning stages of Cognitive Behavioral Therapy (CBT) so I’m learning as much as I can about my disabilities. Which is exactly what they are, disabilities. I have struggled through my life wondering if the physical, and cognitive problems in my life will ever get better. I haven’t seen anything get better, but I have seen it get worse. TBI has caused me to have some extreme Behavioral Health issues. However, I did suffer these prior to my TBI. I am a survivor of childhood/adult sexual assault, also.

It’s just all confusing to me. Where do my Behavioral Health issues stop and my TBI issues start? I believe that is the issue. They inter-meld with each other and the TBI makes my PTSD even worse. I’m in counseling bi-weekly, I think my situation is even confusing for my counselor. I understand that!

Yes, it can get very confusing. I personally believe that the stresses of TBI contribute to PTSD, and they can both look exactly like each other. The thing is — for me, anyway — when I just pick one thing to focus on and address that one thing, what I do helps to deal with both conditions, so it almost doesn’t matter which came first. I can deal with them both.

I have found that my state of mind tends to be directly linked to how I feel physically, and I can get mentally ill from being physically un-well. So, I take care of the basics, focus on eating right and taking care of my physiology, and that helps a lot. I tend to believe that my TBI is the root cause of a lot of the behavioral issues I have — and I have found that regular counselors aren’t much help to me, unless they know about neurology. So many folks want to pin it on psychology, when it’s really neurology. Does that make sense to you?

For remembering the information… it’s different for everyone. For some time — probably a couple of years — I had a laundry list of all the possible problems that I might have on any given day. I was so “out of it” that a lot of my issues were invisible to me, unless I could look at a piece of paper and pinpoint what was going on with me. Until I had that list, I was walking around in a daze and a haze, and I couldn’t tell if I was coming or going. Some people said I was obsessing over my TBI issues and said I was making too much out of them, but it really helped me to get all that out of my head and on paper.

Generally, I am forgetful, so I can completely forget that A leads to B which leads to C… and that’s how I got myself into this new mess. So, I have to keep learning. It can get very disheartening, but don’t give up. Just keep going. And see what you can do to make yourself feel better — in a healthy way.

I had a severe seizure 28 year ago that lasted almost 5 minutes. I still have problems with understanding, communication and memory. My husband says I am a cheap date because I can watch a movie several times before I can remember seeing it. I count on my sister, daughter and husband to be my memory.

5 minutes… that is a really long time. Sorry to hear about your difficulties. I tend to count on others to help me remember things, as well. The good part is, I have figure out how to do it in ways that makes them feel needed and important — instead of making myself look stupid and helpless. Be well.